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Q206 - Two Medical Opinions

Question: 

An employee is stung on their neck by an unknown insect and the on-site nurse observes that the employee is not having a serious reaction and provides ice to reduce minor local swelling. The employee leaves work and decides to see their family doctor. The family doctor provides prescription antibiotics to the employee and recommends taking 2 days off until healed. The employee reports the doctor visit, medical treatment and recommendation for time off work to the employer but the employer asks the employee to visit a different doctor for a second opinion. The same day, the employee visits the second doctor. The second doctor states that they think the antibiotics were unnecessary and clears the employee for work without a need for days away from work. Is it recordable?

Answer:

YES. It is recordable because medical treatment has been provided. OSHA does allow the employer to seek a second opinion and also to choose which opinion is most authoritative. However, as soon as medical treatment as been provided, it must be counted. The second opinion, in this scenario does allow the employer to avoid counting the incident as days away (lost time).

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Letter of Interpretation In certain circumstances, OSHA's recordkeeping requirements permit an employer to choose between two conflicting or differing medical recommendations. When an employer receives contemporaneous recommendations from two or more physicians or other licensed health care professionals about the need for medical treatment, the employer may decide which recommendation is the most authoritative and record the case based on that recommendation. However, once medical treatment is provided for a work-related injury or illness, the case is recordable.












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Q205 - Milk Crate Challenge

Question: 

On their lunch breaks, warehouse employees set up a milk crate challenge. The challenge involves stacking milk crates to create a staircase up and down and then trying to balance your way across it. The first employee to attempt is an office employee, who falls onto the concrete floor. An x-ray shows a fractured collar bone, but no medical treatment, restricted duties or days away are recommended by the doctor. Is it recordable?

Answer:

YES. A fractured bone is considered a significant injury and must be recorded - even if no medical treatment, restricted work or days away occurs. Lunch breaks are considered assigned working hours for injury and illness recordkeeping purposes.

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1904.7(b)(7) OSHA believes that cancer, chronic irreversible diseases, fractured or cracked bones, and punctured eardrums are generally considered significant injuries and illnesses, and must be recorded at the initial diagnosis even if medical treatment or work restrictions are not recommended, or are postponed, in a particular case.

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Letter of Interpretation See, OSHA’s March 10, 2005 letter of interpretation to Milagros Flores. Lunch breaks are considered assigned working hours for injury and illness recordkeeping purposes. See November 15, 2010 letter of interpretation to Kenneth Colonna; February 16, 2010 letter to Scott Hayes. OSHA’s definition of assigned working hours means “those hours the employee is actually expected to work, including overtime.” See FAQ 5-4.

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Under Section 1904.5(b)(2)(v), an injury or illness is not work-related if it is solely the result of an employee doing personal tasks (unrelated to their employment) at the establishment outside of the employee's assigned working hours. In order for this exception to apply, the case must meet both of the stated conditions [i.e., the injury or illness must (1) be solely the result of the employee doing personal tasks (unrelated to their employment), and (2) occur outside of the employee's assigned working hours].












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Q204 - Swallowed Bee

Question: 

A bee flew into the mouth of a maintenance employee who was mowing the grass. The bee became lodged in the employee's throat and stung him. The employee had great difficulty breathing and the occupational health nurse provided the employee with OTC Benadryl. The employee was taken to the emergency room but the doctors did not feel the need to provide any treatment because by the time he arrived he was breathing normally. Is it recordable?

Answer:

NO. The OTC Benadryl is not considered medical treatment beyond first aid because it is a non-prescription drug used at non-prescription strength.

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1904.7(b)(5)(ii) What is "first aid"? For the purposes of Part 1904, \"first aid\" means the following:

1904.7(b)(5)(ii)(A) Using a non-prescription medication at nonprescription strength (for medications available in both prescription and non-prescription form, a recommendation by a physician or other licensed health care professional to use a non-prescription medication at prescription strength is considered medical treatment for recordkeeping purposes);












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